How much rates vary
Facilitymedian $550 · 10th to 90th $126 to $1,413Professionalmedian $126 · 10th to 90th $91 to $155
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $141.25 | Professional | None | $83.18 | $141.25 | $141.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $275.42 Median $977.24 Typical High $1,412.54 | Facility | None | $275.42 | $977.24 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $154.88 | Professional | None | $120.23 | $138.04 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $138.04 | Professional | None | $102.33 | $120.23 | $138.04 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $141.25 Typical High $199.53 | Facility | None | $64.57 | $141.25 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $154.88 | Professional | None | $100.00 | $134.90 | $154.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $109.65 Median $125.89 Typical High $125.89 | Facility | None | $109.65 | $125.89 | $125.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | None | $125.89 | $125.89 | $154.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,412.54 | Facility | None | $776.25 | $1,122.02 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | None | $120.23 | $120.23 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $66.07 Typical High $1,548.82 | Facility | None | $64.57 | $66.07 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $102.33 | Professional | None | $64.57 | $64.57 | $102.33 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $169.82 | Professional | None | $85.11 | $117.49 | $169.82 |
19 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $41.69 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $16.60 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $12.59 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.32 | $14.13 | $14.13 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $309.03 Median $1,412.54 Typical High $1,949.84 | Facility | 50 · Both sides | $309.03 | $1,412.54 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $218.78 Typical High $234.42 | Professional | 50 · Both sides | $181.97 | $218.78 | $234.42 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $109.65 | $128.82 | $141.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.45 Typical High $15.49 | Professional | 55 · Aftercare only | $12.02 | $14.45 | $15.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $75.86 Median $89.13 Typical High $97.72 | Professional | 62 · Two surgeons | $75.86 | $89.13 | $97.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $144.54 Median $173.78 Typical High $186.21 | Professional | 63 · Small infant | $144.54 | $173.78 | $186.21 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $100.00 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $85.11 | $100.00 | $109.65 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $22.91 Typical High $25.12 | Professional | 80 · Assistant surgeon | $19.50 | $22.91 | $25.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $22.91 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $19.50 | $22.91 | $25.12 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $22.91 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $22.91 | $25.12 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $19.50 Typical High $21.38 | Professional | AS · PA/NP assist | $16.60 | $19.50 | $21.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $50.12 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.00 | $14.13 | $14.13 |
Where Idaho sits
The same service costs 4.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 14th of 51
$138
AK $316KY $70.79
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.